High Paying Utilization Review Nurse Jobs Remote Full Time

Are you seeking for high paying utilization review nurse jobs remote to further your nursing career? Look no further than Optum, a leading healthcare company now hiring remote utilization review nurses to join its dynamic team.

High Paying Utilization Review Nurse Jobs Remote Important Details

• Jobs Category: Remote Nursing Jobs
• Appointing Organization: Optum
• Type of Job: Remote/ Full-time
• Deadline to Apply: April 27, 2025
• Reporting To: Nursing Supervisor

What is Utilization Review Nursing?

Utilization review nursing is a specialized field that evaluates the medical necessity and appropriateness of patient healthcare services. Nurses in this role work closely with physicians, insurance companies, and other healthcare professionals to ensure that patients receive appropriate care while also working to control healthcare costs.

About Us

Optum Inc. is an American based healthcare company that provides various services, including data analytics, technology solutions, and consulting to help improve the overall delivery and effectiveness of healthcare.

What Will Be Your Responsibilities?

As a remote utilization review nurse at Optum, your responsibilities will include:

• Conducting in-depth reviews of medical records: Your role will involve reviewing medical records and documentation to determine the necessity and appropriateness of healthcare services.
• Collaborating with healthcare professionals: You will work closely with physicians, specialists, and other healthcare providers to gather information and collaborate on care plans
• Analyzing data: Utilizing your critical thinking skills, you will analyze data from medical records, insurance claims, and other sources to make informed decisions about appropriate levels of care.
• Communicating with insurance companies: Your role may also involve communicating with insurance companies to justify services rendered
• Ensuring compliance: As a utilization review nurse, you will follow guidelines and regulations to ensure healthcare policies and procedures compliance.
• Make sure UM Nurse reviewer, can easily follow-up on medical record review: As a utilization review nurse, you will ensure that all documentation is organized and clear for the UM Nurse Reviewer to easily follow up on medical record reviews. And make sure that UM Nurse Reviewer has efficiently provided the necessary feedback to healthcare providers.

What We Look For?

At Optum, we are looking for dedicated and experienced utilization review nurses who possess the following qualifications:

• A current nursing license: We will prefer applicants with an active and unrestricted nursing license in their state of residence.
• Education: Graduation in nursing from an accredited institution with at least 3 years of experience in utilization review and/or acute care.
• Strong communication skills: Effectively communicating with healthcare professionals, insurance companies, and other stakeholders is crucial for this role.
• HMO Experience: Candidates with prior experience working in a Health Maintenance Organization (HMO) setting will be preferred.
• Attention to detail: As a utilization review nurse, you must be detail-oriented to accurately analyze medical records and make informed decisions.
• Critical thinking abilities: Making objective decisions about patient care requires strong critical thinking skills.

Why Choose Optum for Remote Utilization Review Nursing Jobs?

As a remote utilization review nurse at Optum, you’ll have the opportunity to work with a diverse team of healthcare professionals and make a real impact on patient care. Additionally, here are some reasons why choosing Optum for your next nursing job may be the right choice for you:

• Competitive Salary: Optum offers highly competitive employee salaries, including remote utilization review nurses. Most of our employs earn 6300$-6800$ per month based on their education, experience, and skill level.
• Flexibility: We understands the value of work-life balance and offers flexible work arrangements, including remote positions. This gives nurses more control over their schedules and potentially reduces commute time and expenses.
• Training and Development: At Optum, we are committed to helping our employees grow personally and professionally. We offer various training programs and development opportunities to help you advance in your career as a utilization review nurse.
• Opportunities for advancement: With our diverse range of healthcare services, there are plenty of opportunities for career growth and advancement
• Benefits package: We also offer a comprehensive benefits package that includes medical, dental, vision, and retirement plans.

Apply Now!

Are you ready to join the team at Optum as a remote utilization review nurse? We invite you to apply now and take the next step in your nursing career with us! Email us your resume, and our recruitment team will contact you.